Bordetella holmesii Bacteremia Cases in the United States, April 2010–January 2011

Bordetella holmesii is a gram-negative, nonoxidizing, slow-growing organism first identified as a species in 1995 [1]. Relatively little is known about the epidemiology, clinical manifestations, or natural history of B. holmesii. Unlike Bordetella pertussis, B. holmesii has been associated with invasive disease in immunocompromised persons, primarily bacteremia in young adults with sickle-cell anemia [2–6]. Although B. holmesii has not been historically associated with a cough illness, more recently the pathogen has been associated with a pertussis-like respiratory syndrome in healthy individuals [7–9]. Prior knowledge about B. holmesii bacteremia has come from single case reports or small case series [3–6, 10]. The largest published series described all B. holmesii bacteremia cases (n = 30) identified by the Centers for Disease Control and Prevention (CDC) over a 17-year period (1983–2000) [2]. Between 12 June 2010 and 13 August 2010, the New York City Department of Health and Mental Hygiene (NYC DOHMH) Public Health Laboratory received 4 Bordetella holmesii blood isolates submitted for confirmatory testing from 4 New York City hospitals. On 23 August 2010, B. holmesii was isolated from a fifth blood specimen at a New York City hospital laboratory. This number of cases was above baseline for that time period based on historic records. We describe the first reported investigation of temporally related B. holmesii bacteremia cases.